October is National Breast Cancer Awareness Month. One in eight women will develop breast cancer in her lifetime. About 182,000 American women developed breast cancer last year alone. It kills nearly 46,000 American women each year. According to the American Cancer Society, breast cancer is the most common form of cancer among American women. Every woman is at risk for it.
Breast cancer is thought of as a woman’s disease, but men can also develop a form it. Each year, over 400 men die from breast cancer.
The incidence of breast cancer has continued to increase at about 2 percent a year, but the death rate has declined. This decrease is believed to be the result of earlier detection and improved treatment. But 2 percent of the autopsies performed in 2003 showed undiagnosed breast cancer. That means a lot more women have breast cancer and don’t know it.
Breast cancer occurs when a group of cells grows out of control and divide more than they should, forming masses called tumors. Some tumors do not spread to other parts of the body, but may interfere with body functions and require removal. These are known as benign tumors. Malignant (or cancerous) tumors invade and destroy normal tissue, then break from the original tumor and migrate to other parts of the body and may form other malignant tumors. Breast cancer can spread through the lymph nodes to the lungs, liver, bone and brain.
Dr. Elizabeth Patterson, a radiologist at the Hospital of the University of Pennsylvania, said cancer is an attempt of abnormal cells to overtake the normal cells and spread. The incidence of breast cancer in African-American women is less than in the general population, she said, but the death rate is higher. According to a National Cancer Institute study, African-American women are 2.2 times more likely to die from breast cancer than their white counterparts. Black women generally have more aggressive breast cancer and have shorter survival times than white women. It’s been estimated that when comparing white and Black women with breast cancer, Black women had between a 70–90 percent increased risk of dying from it than white women, independent of the stage in which the cancer was diagnosed.
Some studies have argued that the difference in breast cancer mortality between Black and white women reflects different standards of care of women who have different incomes. This could be true, but it does not answer the question of why Black women have more aggressive breast cancer than white women, nor does it explain why breast cancer mortality rates have risen faster in young Black women than in young white women.
Breast cancer is the second leading cause of cancer death among African-American women. The incidence for women under 40 was higher among Black women than among whites, but it is increasing in both the young Black and white populations. However, young Black women are getting more breast cancer and dying from it more often than young white women.
Patterson suggested, “There are several reasons (for the disparity). African-American women tend to seek treatment during latter stages of the disease process. Denial is a big problem which allows time for the disease to spread to other parts of the body.”
Many myths keep women from seeking treatment. These include, “Cancer is a death sentence;” “Once surgery takes place and the cancer is exposed to air, it will spread like wildfire,” and many women don’t believe there is a cure. Patterson believes that these myths exist partly because there aren’t any highly visible African-American role models to show that cancer can be cured and that one can resume a normal lifestyle. Studies show that African-American women don’t think of cancer as one of their diseases. Many older women believe the myth there is something wrong with touching their own bodies. There’s also a lack of awareness about the importance of mammograms and a lack of access to the health-care system, said Patterson. The survival rate is very good when breast cancer is detected and treated early, she said. On an encouraging note, she did say that young African-American women are more aware and do perform self-examinations more frequently.
It is not known what causes breast cancer or how to prevent it. It’s known that the risk for developing it is greater in some women whose mother, sister or other close relative has had it. White women are slightly more likely to get breast cancer than are African-American women. But African Americans are more likely to die of this cancer. Although Asian, Hispanic and American Indian women have a lower risk of getting breast cancer, studies show that there has been a big increase in the numbers of these women developing breast cancer.
Women are at risk for breast cancer if they:
· are over age 40 and especially over 50.
· have already had cancer in one breast.
· have close relatives who had breast cancer before age 50 or menopause.
· take menopausal hormone therapy (either estrogen alone or estrogen plus progestin) for five or more years after menopause.
· had their first menstrual period before age 12.
· went through menopause after age 55 or never had children.
· show mostly dense tissue on a mammogram.
· are obese after menopause.
· are physically inactive throughout life.
· have had no children, or who had their first child after age 30.
· have 2 to 5 drinks daily.
Women with one or more of these risk factors should examine their breasts monthly. They should also have a health-care professional examine them regularly.
The most common sign of breast cancer is a lump or thickening that does not go away or change how it feels. Keep in mind that four out of 5 lumps are benign and not cancerous. Other signs to look for are swelling, puckering or dimpling, redness, and soreness of the skin or nipple discharge. The nipple may become drawn into the chest, change shape, bleed or become crusty. Usually, early breast cancers are painless but if you experience pain and tenderness throughout your menstrual cycle, you should tell your physician.
Patterson said treatment of cancer may use a combination of therapies, Patterson said, including radiation, a lumpectomy, a partial, modified or full mastectomy, chemotherapy and hormonal therapy.
Patterson said families should talk about it more and be open about the disease. Every woman should have a baseline mammogram between the ages of 35 and 39 to help detect changes in later years. Between ages 40 and 50, a woman should have one every one to two years. Those over 50 should have a mammogram every year.
Breast cancer is not a death sentence and neither are the treatments, stressed Patterson.
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